The American Dental Association recently commented on CMS' proposal to provide dental coverage under certain medically necessary conditions.
Nine things to know:
1. CMS released its proposal to cover additional dental services required for a patient's primary medical condition in July.
2. In comments filed Sept. 2, ADA President Cesar Sabates, DDS, and Executive Director Raymond Cohlmia, DDS, applauded CMS' proposal.
3. The ADA told CMS that coverage of ridge reconstruction as a result of surgical removal of a tumor should be available in all instances.
4. The dental agency asked for clarity from CMS regarding certain claims and payment policies for dentists in outpatient settings.
5. The ADA maintained that tooth extractions should be a last resort for clearing an infection prior to a procedure and urged CMS to consider covering other treatment options.
6. The ADA asked CMS to collect and evaluate relevant data for more than 700 CDT codes to develop a viable fee schedule for dental services.
7. The dental organization noted that CMS' comment period did not allow for a comprehensive review of evidence regarding the need for dental services for the success of certain covered medical services, but cited a lack of evidence showing that dental services are integral for the reduction of urgent pre-radiation treatment and risk of osteoradionecrosis of the jaw, as well as improved outcomes after orthopedic surgery.
8. The ADA shared a study with CMS showing how periodontal therapy can improve glycemic control for people with diabetes and asked CMS to conduct a cost analysis of expanding dental benefits for people with diabetes.
9. The ADA expressed the importance of supporting dentists, including financially, with the coordination of care between healthcare providers for optimal patient outcomes.